Clinical Code Editing

Compass systematizes the technology applied to code validation use on claims that has too often been left for manual review by medical professionals. Beacon has designed Compass to precisely analyze all incoming claims for appropriateness and accuracy from a medical billing and coding appropriateness standpoint. The system flags claims that attempt to bill incompatible or unnecessary procedures, performing checks for medically unlikely or unnecessary combinations of edits, along with a host of other checks for reasonableness. Controls for code edit values allow you to deny, pend, ignore, or fire an alert for incoming in- and out-of-network claims. When necessary, the system will examine claim history for code verifications.

Compass Code Edits systematizes the technology applied to code validation use on claims that has too often been left for manual review by medical professionals. Beacon has designed Compass to analyze all incoming claims for compliance and accuracy from a medical billing and coding appropriateness standpoint. The system flags claims that attempt to bill incompatible or unnecessary procedures by performing checks for medically unlikely or unnecessary combinations of events or codes, along with a host of other checks for reasonableness.

Controls are available for users to design and implement procedures within your smart workflow queues to automatically pend or deny claims flagged by Compass to the appropriate department for review. Compass increases end-to-end efficiency by allowing you to spend less time on manual review. Enhance your claims adjudication process with Compass by adding increased accuracy and appropriateness checks for claims.

Features:

Identification of services that may have unnecessary, inappropriate, or incompatible codes